Parametric interaction of laser cavity-solitons with an external CW pump.

We study the interaction of a laser cavity-soliton microcomb with an externally coupled, co-propagating tunable CW pump, observing parametric Kerr interactions which lead to the formation of both a cross-phase modulation and a four-wave mixing replica of the laser cavity-soliton. We compare and explain the dependence of the microcomb spectra from both the cavity-soliton and pump parameters, demonstrating the ability to adjust the microcomb externally without breaking or interfering with the soliton state. The parametric nature of the process agrees with numerical simulations. The parametric extended state maintains the typical robustness of laser-cavity solitons.

Terahertz Spatiotemporal Wave Synthesis in Random Systems.

Complex media have emerged as a powerful and robust framework to control light-matter interactions designed for task-specific optical functionalities. Studies on wavefront shaping through disordered systems have demonstrated optical wave manipulation capabilities beyond conventional optics, including aberration-free and subwavelength focusing. However, achieving arbitrary and simultaneous control over the spatial and temporal features of light remains challenging. In particular, no practical solution exists for field-level arbitrary spatiotemporal control of wave packets. A new paradigm shift has emerged in the terahertz frequency domain, offering methods for absolute time-domain measurements of the scattered electric field, enabling direct field-based wave synthesis. In this work, we report the experimental demonstration of field-level control of single-cycle terahertz pulses on arbitrary spatial points through complex disordered media.

Intracoronary Imaging Versus Coronary Angiography Guidance for Implantation of Second and Third Generation Drug Eluting Stents in a Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Intracoronary imaging (ICI) facilitates stent implant by characterizing the lesion calcification, providing accurate vessel dimensions, and optimizing the stent results. We sought to investigate the outcomes of routine ICI versus coronary angiography (CA) to guide percutaneous coronary intervention (PCI) with second- and third-generation drug-eluting stents. A systematic search of PubMed, Medline, and Cochrane databases was conducted from their inception to July 16, 2022 for randomized controlled trials comparing routine ICI with CA. The primary outcome was major adverse cardiovascular events. The secondary outcomes of interest were target lesion revascularization, target vessel revascularization, myocardial infarction, stent thrombosis, and cardiac and all-cause mortality. A random-effects model was used to calculate the pooled incidence and relative risk (RR) with 95% confidence intervals (CIs). A total of 9 randomized controlled trials with 5,879 patients (2,870 ICI-guided and 3,009 CA-guided PCI) met the inclusion criteria. The ICI and CA groups were similar in demographic characteristics and co-morbidity profiles. Compared with CA, patients in the routine ICI-guided PCI group had lower rates of major adverse cardiovascular events (RR 0.61, 95% CI 0.48 to 0.78, p <0.0001), target lesion revascularization (RR 0.60, 95% CI 0.43 to 0.83, p = 0.002), target vessel revascularization (RR 0.72, 95% CI 0.51 to 1.00, p = 0.05), and myocardial infarction (RR 0.48, 95% CI 0.25 to 0.95, p = 0.03). There were no significant differences in stent thrombosis or cardiac/all-cause mortality between the 2 strategies. In conclusion, routine ICI-guided PCI strategy, compared with CA guidance alone, is associated with improved clinical outcomes, largely driven by lower repeat revascularization.

Terahertz Nonlinear Ghost Imaging via Plane Decomposition: Toward Near-Field Micro-Volumetry.

Terahertz time-domain imaging targets the reconstruction of the full electromagnetic morphology of an object. In this spectral range, the near-field propagation strongly affects the information in the space-time domain in items with microscopic features. While this often represents a challenge, as the information needs to be disentangled to obtain high image fidelity, here, we show that such a phenomenon can enable three-dimensional microscopy. Specifically, we investigate the capability of the time-resolved nonlinear ghost imaging methodology to implement field-sensitive micro-volumetry by plane decomposition. We leverage the temporally resolved, field-sensitive detection to "refocus" an image plane at an arbitrary distance from the source, which defines the near-field condition, and within a microscopic sample. Since space-time coupling rapidly evolves and diffuses within subwavelength length scales, our technique can separate and discriminate the information originating from different planes at different depths. Our approach is particularly suitable for objects with sparse micrometric details. Building upon this principle, we demonstrate complex, time-domain volumetry resolving internal object planes with subwavelength resolution, discussing the range of applicability of our technique.

Kounis Syndrome: A Sting to the Heart.

A 67-year-old woman experienced pruritus, an urticarial rash, and acute, pressure-like chest pain following an insect sting. Initial electrocardiographic findings were notable for ST-segment elevations in the inferior leads without reciprocal changes, but a follow-up electrocardiogram showed pronounced ST-segment elevations in the inferior leads with reciprocal changes. Her troponin I level peaked at 3,053 pg/mL, and she was transferred to a large academic center for percutaneous coronary intervention. Balloon angioplasty was performed for 95% thrombotic occlusion of the mid-right coronary artery, and a drug-eluting stent was placed. The patient's presentation was consistent with type II Kounis syndrome.

High parametric efficiency in laser cavity-soliton microcombs.

Laser cavity-soliton microcombs are robust optical pulsed sources, usually implemented with a microresonator-filtered fibre laser. In such a configuration, a nonlinear microcavity converts the narrowband pulse resulting from bandwidth-limited amplification to a background-free broadband microcomb. Here, we theoretically and experimentally study the soliton conversion efficiency between the narrowband input pulse and the two outputs of a four-port integrated microcavity, namely the 'Drop' and 'Through' ports. We simultaneously measure on-chip, single-soliton conversion efficiencies of 45% and 25% for the two broadband comb outputs at the 'Drop' and 'Through' ports of a 48.9 GHz free-spectral range micro-ring resonator, obtaining a total conversion efficiency of 72%.

Deterministic Terahertz Wave Control in Scattering Media.

Scattering-assisted synthesis of broadband optical pulses is recognized to have a cross-disciplinary fundamental and application importance. Achieving full-waveform synthesis generally requires means for assessing the instantaneous electric field, i.e., the absolute electromagnetic phase. These are generally not accessible to established methodologies for scattering-assisted pulse envelope and phase shaping. The lack of field sensitivity also results in complex indirect approaches to evaluate the scattering space-time properties. The terahertz frequency domain potentially offers some distinctive new possibilities, thanks to the availability of methods to perform absolute measurements of the scattered electric field, as opposed to optical intensity-based diagnostics. An interesting conceptual question is whether this additional degree of freedom can lead to different types of methodologies toward wave shaping and direct field-waveform control. In this work, we theoretically investigate a deterministic scheme to achieve broadband, spatiotemporal waveform control of terahertz fields mediated by a scattering medium. Direct field access via time-domain spectroscopy enables a process in which the field and scattering matrix of the medium are assessed with minimal experimental efforts. Then, illumination conditions for an arbitrary targeted output field waveform are deterministically retrieved through numerical inversion. In addition, complete field knowledge enables reconstructing field distributions with complex phase profiles, as in the case of phase-only masks and optical vortices, a significantly challenging task for traditional implementations at optical frequencies based on intensity measurements aided with interferometric techniques.

Route to Intelligent Imaging Reconstruction via Terahertz Nonlinear Ghost Imaging.

Terahertz (THz) imaging is a rapidly emerging field, thanks to many potential applications in diagnostics, manufacturing, medicine and material characterisation. However, the relatively coarse resolution stemming from the large wavelength limits the deployment of THz imaging in micro- and nano-technologies, keeping its potential benefits out-of-reach in many practical scenarios and devices. In this context, single-pixel techniques are a promising alternative to imaging arrays, in particular when targeting subwavelength resolutions. In this work, we discuss the key advantages and practical challenges in the implementation of time-resolved nonlinear ghost imaging (TIMING), an imaging technique combining nonlinear THz generation with time-resolved time-domain spectroscopy detection. We numerically demonstrate the high-resolution reconstruction of semi-transparent samples, and we show how the Walsh-Hadamard reconstruction scheme can be optimised to significantly reduce the reconstruction time. We also discuss how, in sharp contrast with traditional intensity-based ghost imaging, the field detection at the heart of TIMING enables high-fidelity image reconstruction via low numerical-aperture detection. Even more striking-and to the best of our knowledge, an issue never tackled before-the general concept of "resolution" of the imaging system as the "smallest feature discernible" appears to be not well suited to describing the fidelity limits of nonlinear ghost-imaging systems. Our results suggest that the drop in reconstruction accuracy stemming from non-ideal detection conditions is complex and not driven by the attenuation of high-frequency spatial components (i.e., blurring) as in standard imaging. On the technological side, we further show how achieving efficient optical-to-terahertz conversion in extremely short propagation lengths is crucial regarding imaging performance, and we propose low-bandgap semiconductors as a practical framework to obtain THz emission from quasi-2D structures, i.e., structure in which the interaction occurs on a deeply subwavelength scale. Our results establish a comprehensive theoretical and experimental framework for the development of a new generation of terahertz hyperspectral imaging devices.

Post-discharge opioid prescribing after laparoscopic appendicectomy and cholecystectomy.

BACKGROUND: Opioid over-prescription following surgery is a significant public health issue in most developed countries. Multiple studies have been conducted in the USA demonstrating and investigating the issue; however, there is a lack of literature addressing this topic in the Australian setting. The aim of this study is to review prescribing practices at an Australian tertiary referral hospital on discharge in patients having undergone laparoscopic cholecystectomy (LC) or laparoscopic appendicetomy (LA). Additionally, to identify potential factors which influence medical officer prescribing practices. METHODS: A retrospective observational study on opioid prescribing practice on all patients who underwent LC or LA over a 12-month period at an Australian tertiary referral hospital. RESULTS: A total of 435 patients (223 LC, 214 LA) were prescribed a mean opioid dose on discharge of 25 oral morphine milli-equivalents (range 0-180 morphine milli-equivalents). Less opioids were prescribed following elective procedures (42% versus 10%, P < 0.001). There is a downward trend of opioid prescribing on discharge as the Junior Medical Officer clinical year progresses (P < 0.001). CONCLUSIONS: This study demonstrates a lower rate of opiate prescription on discharge for LC and LA in an Australian setting when compared to the US data. There is a wide diversity of prescribing demonstrated. This indicates the need for better training of opioid prescribers to reduce over-prescribing.

Can water float on oil?

The floatability of water on oil surface was studied. A numerical model was developed from the Young-Laplace equation on three interfaces (water/oil, water/air, and oil/air) to predict the theoretical equilibration conditions. The model was verified successfully with an oil/water system. The stability of the floating droplet depends on the combination of three interface tensions, oil density, and water droplet volume. For practical purposes, however, the equilibrium contact angle has to be greater than 5° so the water droplet can effectively float. This result has significant applications for biodegrading oil wastes.